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Fulminant hepatitis: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
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[ What causes fulminant hepatitis?
Fulminant hepatitis is sometimes caused by HBV, and up to 50% of cases of fulminant hepatitis B are co-infected with HDV. Fulminant hepatitis with HAV is rare, but may occur in people with underlying liver disease. The role of HCV remains unclear.
Symptoms of fulminant hepatitis
Patients rapidly deteriorate due to the development of portosystemic encephalopathy, often progressing to coma within hours or days, sometimes with cerebral edema. Bleeding is usually due to liver failure or disseminated intravascular coagulation and functional renal failure (hepatorenal syndrome). Increased PT, portosystemic encephalopathy, and especially renal failure are poor prognostic signs.
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Treatment of fulminant hepatitis
With careful care and aggressive treatment of complications, the outcome may be more favorable. However, only emergency liver transplantation provides the best chance of recovery. Adult patients rarely survive without a liver transplant; children have a better chance. Patients who survive usually recover completely.